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0093/2026 - Paradox of the Success of antiretroviral therapy (HAART): Experiences of Treatment Interruption for HIV/AIDS in Porto Alegre, Rio de Janeiro, and Manaus
Paradoxo do sucesso da TARV: Experiências de abandono de tratamento para o HIV/AIDS em Porto Alegre, Rio de Janeiro e Manaus

Author:

• Andréa Fachel Leal - Leal, AF - <dea.leal@gmail.com>
ORCID: https://orcid.org/0000-0003-1947-9579

Co-author(s):

• Daniela Knauth - Knauth, D - <daniela.knauth@gmail.com>
ORCID: https://orcid.org/0000-0002-8641-0240
• Pamela Ximena Bermudez - Bermudez, PX - <ximenapam@gmail.com>
ORCID: https://orcid.org/0000-0002-3771-7684
• Ivia Maksud - MAKSUD, I - <iviamaksud@gmail.com>
ORCID: https://orcid.org/0000-0002-3465-151X


Abstract:

The purpose of this article is to analyze factors contributing to treatment discontinuation among people living with HIV (PLHIV). The study draws on qualitative data from 30 in-depth interviews conducted in three Brazilian cities: Porto Alegre (9), Rio de Janeiro (10), and Manaus (11). Findings indicate that treatment interruption is rarely the result of a deliberate decision; rather, it emerges from structural, institutional, and biographical factors. In Manaus, respondents emphasized inadequate healthcare experiences and changes in primary providers as key triggers for discontinuity. In Rio de Janeiro, organizational dynamics within health services—such as failure to honor scheduled appointments—were identified as significant, often compelling individuals to miss work or arrive late, creating tensions between health and livelihood. In Porto Alegre, life-course disruptions were particularly salient, as they sever ties with providers and require effort to reestablish care. A paradox emerges wherein improved health and quality of life from antiretroviral therapy (ART) leads individuals to suspend treatment when they feel well. Despite these challenges, participants acknowledged the benefits of ART and expressed willingness to resume treatment, framing the interview process as an opportunity for reflection on adherence.

Keywords:

HIV, antiretroviral therapy (HAART), Treatment Interruption

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Leal, AF, Knauth, D, Bermudez, PX, MAKSUD, I. Paradox of the Success of antiretroviral therapy (HAART): Experiences of Treatment Interruption for HIV/AIDS in Porto Alegre, Rio de Janeiro, and Manaus. Cien Saude Colet [periódico na internet] (2026/Apr). [Citado em 17/09/2026]. Está disponível em: http://www.cienciaesaudecoletiva.com.br/en/articles/paradox-of-the-success-of-antiretroviral-therapy-haart-experiences-of-treatment-interruption-for-hivaids-in-porto-alegre-rio-de-janeiro-and-manaus/19991?id=19991&id=19991



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